The following is gathered from information generally available to the public and is provided for educational purposes only. It is not to be considered legal advice.
Florida is an “income cap” state with respect to Medicaid long-term care benefits in that an individual with gross countable income exceeding $2,901.00 (in 2025) per month is ineligible to receive benefits for Medicaid nursing home or Home and Community Based Services.
There is a cure for this problem, however, in that federal and state law permits the establishment and funding of an “Irrevocable Qualified Income Trust” or “QIT” to “shelter” the excess income and allow for eligibility. This trust arrangement may also be referred to as a “Medicaid Income Trust” or a “Miller Trust”.
This is a simple grantor trust whereby the Medicaid recipient is giving up rights to the income he or she is receiving above the Income Cap specified above and stipulating that this income will be used for their own health, maintenance, and welfare.
The Medicaid applicant cannot be trustee of their own trust. Generally, a family member will serve as trustee although virtually anyone who agrees to do so may serve. There will be no compensation for the services the trustee renders.
Once the QIT is drafted, the trustee of the trust will go a bank and open an account titled in the name of the trust and deposit AT LEAST the amount of the Medicaid applicant’s gross monthly income that exceeds the Medicaid Income Cap. It is better to over fund the trust than risk under funding the trust.
The QIT must be established and funded before the end of the month in which the applicant is seeking benefits.
The QIT must then be funded by the end of each ensuing month for which benefits are being applied for or being received, income in excess of income the Income Cap must be deposited into a bank account titled in the name of the QIT.
The QIT can only accept income, not assets.
Payments from the QIT must be for the benefit of the recipient as described in the trust document and as agreed to by the Department of Children and Families (DCF). Typically, the income (less any Personal Needs Allowance and other deductions permitted by DCF) will be paid to a nursing home, assisted living facility, for home care, or other permitted purpose. In general, income deposited to the QIT can only be used for the “medical needs” of the recipient.
It is wise to carefully manage the QIT account balance as any residual remaining in the QIT bank account at the demise of the recipient must be paid back to the State of Florida to the extent the state provided benefits. When properly managed, the amount due the state should be $0.